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... but never paramedics?

[rant]

Loudmouth Representative Peter King ranted about it this past weekend. Heard it again today. Some politician praising firefighters and cops as "America's real heroes." But, paramedics are never included.

Paramedics aren't firefighters in most parts of the country. The EMS services are a third branch of public safety. Paramedics crawl into derailed locomotives to treat the injured crew. They crawl into crumpled wrecks of cars to stop spurting arteries. They dive to the bottom of the pool to get the drowned baby. And they fight off the knife-whelding druggies on the street. Then there's all the AIDS, hepatitis, and other communicable disease exposure.

Why do people diss paramedics when it comes to the hero shit?

[/rant]

Mark wrote:hero shit?

If it's nothing more than "shit", then why does it concern you?

Our paramedics up here work for the Fire Department.

I think often times people lump them into the same group. When one sees a "Rescue" unit go by in Anchorage it's Red, and has Anchorage Fire Department plastered all over it. Ditto Chugiak, ditto Kenai, ditto Homer, ditto Fairbanks, ditto, ditto, ditto.

I think paramedics are lumped in - incorrectly perhaps - with firefighters.

Queso wrote:

Mark wrote:hero shit?

If it's nothing more than "shit", then why does it concern you?

Annoyed colloquialism in this case.

Mark does bring up a valid point. EMS has many problems, such as lack of education and crappy hours, but it has been becoming better. EMS agencies are being absorbed by fire departments so that they can claim increased call volume. To some degree, this has resulted in firefighters getting their -Ps so that they get a pay raise, which means that some "medical providers" are not medically focused, instead being pressured into the job. I know of a fire/rescue department that cadrioverted a girl having seizures...and then there was the recent DC debacle with the cheating to pass the NREMT.

This issue is harder to appreciate for people not in either field, and the subject matter is quite broad. It can be alienating to work a 15 hour shift non-stop due to holdovers and receive no credit for it. I can't count the number of times that something my medic did has been attributed to someone who doesn't have any medical knowledge. HIPAA also means that many fire departments can brag.

EMS is certainly not the place to go for glory, but one shouldn't go there for such a thing.

One medic I know saved a pedi-code in a burning building, and the news crews got all sorts of footage and pictures. The article the next morning showed three firefighters with a puppy in front of the destroyed home and had the title that said, "Fire Crews Save Puppy Against All Odds." Oh well, we did our job and hopefully someone will recognize us for it.

My main problem is with the potential for degradation of prehospital care do to firecentric takeover and an emphasis away from progressive, practical medical practices.

Good topic Mark!

ANCFlyer wrote:Our paramedics up here work for the Fire Department.

I think often times people lump them into the same group. When one sees a "Rescue" unit go by in Anchorage it's Red, and has Anchorage Fire Department plastered all over it. Ditto Chugiak, ditto Kenai, ditto Homer, ditto Fairbanks, ditto, ditto, ditto.

I think paramedics are lumped in - incorrectly perhaps - with firefighters.

Imagine if the Fire Departments took over the PDs. Doesn't make sense, does it? Now imagine if they took over the PD and paid the LEOs many thousands less than a "true firefighter." This does happen in some places.

Other places do it right with fire, like Seattle. Many do it wrong, like LA.

The amount of funding that fire gets is astronomical. EMS is not funded well, usually, and often the private companies are more screwed up than the airlines. We don't get much money from 9-1-1s and we can't recover money and downtime from all the drunks and transients. Many, cough Ah My Ride cough, make up for this by screwing IFT patients and BLS transfers.

Lucas wrote:
My main problem is with the potential for degradation of prehospital care do to firecentric takeover and an emphasis away from progressive, practical medical practices.

I can't count the number of fricking times I've arrived on a scene to see the firefighters doing some dumbassed first aid thing to a patient with a more pressing medical issue. There's the time I nearly had to slap a trio of firefighters into doing CPR on a person; they were convinced that splinting the broken arm was the priority. Then there's the time I had a person showing signs of a torn aorta; the fire dept. was dinging around trying to figure out how to cut the car apart to cause the least amount of damage....just take the fricking roof off!!!

A few years ago, the level one trauma center in St. Paul did a study to find why, a) so many overdose patients from a particular suburb of the Twin Cities arrived by car rather than ambulance, and b) why that suburb had twice as many in-home deaths from overdoses.

Hell...I came up with the reason within ten seconds. The EMS Department was operated by the police department. Duh!

I can certainly imagine that happening. I want to make it clear that I'm trying not to paint with a very broad brush, because there are going to be many fire-based medics that are great, and many EMS-based medics that aren't. Still, it is absolutely clear from working in the field that many fire departments consider themselves FIRE departments that have to work with annoying sick people to maintain their comfortable pay level. Really, what's more glorious, putting out a fire or taking a CC transfer where no one sees you?

This is an issue that many in the public simply don't see or understand, just as many in the public don't understand the difference between an EMT-B and -P. The USA has the potential to have an excellent prehospital care system, but there are many things conspiring against us, and "Engine Three, Rescue One, Techincal Two, and Medic 14 Please Respond to XXXXX for a 35 y/o man who..." is part of the problem.


Anyway, a LOT of people don't have a clue about the people helping them and the level of screwed up crap that is accepted. That's why drove to a fire station to pick up a woman with an active MI who had her husband driver her 16 blocks to the fire station she always saw so that they could help her, and the firemen screwed up and couldn't get an IV three times and planned on giving D50 b/c of diabetic hx. Why did she go to the fire station for medical care? Because she always saw a big red truck going along with a small ambulance and assumed that was the place to go. Would she have gone to the fire station if a robber was in her house? Probably not.

Anyway, like I've said, many fire departments are less needed than they used to be while the need for medical care is on the rise. (Wildfires are different!) Losing medical competency is unfortunately a real issue. The media fails to note either of these problems.

Something I've never figured out is why municipalities don't bat an eye when the fire chief shows up at a city council meeting requesting a $141.00 per household subsidy to operate the fire department, yet piss and moan when EMS asks for a $7 per capita subsidy to operate EMS. Is property more important than the preservation of human life?

EMS don't have strong unions, do they?

AndesSMF wrote:EMS don't have strong unions, do they?

That's one area of EMS I know little about. The local medics are now part of the same union representing city utility workers. IIRC, EMS that isn't fire-based or privately-owned tends to be represented by small unions. I've never heard of a Teamsters-type organization that specifically covers EMS folks.

I don't consider cops and firefighters (as well as doctors, nurses, emt's, paramedics teachers etc) heroes. We voluntarily signed up for this line of work, therefore were just "doing our job". Firefighters please..1% of their time is fighting some kind of fire. In the early 1970's many communities were looking at the concept of Public Safety Departments so they could cut down on the number of firemen and police officers would perform the same services as a fireman,needless to say this idea wasn't popular with either side. The bottom line is that fire departments just aren't cost effective. Since the 1970's the fire departments have waged a very effective PR effort to justify their existence. For instance, why the do fire departments seem to think they have to respond to every auto accident in there big ass trucks, then have 3 or 4 of them just stand around?

In conclusion, my idea of a hero, is a civilian that risks his life to save another, or the military member that goes beyond the call of duty.

BlueLion wrote:For instance, why the do fire departments seem to think they have to respond to every auto accident in there big ass trucks, then have 3 or 4 of them just stand around?

Liability. Besides, the fire department does the actual cutting apart of the vehicles. And anytime you have leaking gas and other fluids, you need a charged line in case a fire breaks out when the medics are working on the patients in the wrecked vehicles.

If you didn't have fire trucks there with their rescue tools and water, then you'd simply have EMS vehicles there doing the same service. You need one ambulance for every critical patient (or every two minimally-injured patients). A rescue truck with the tools and a pumper-type truck with the water and foam at a minimum.

Like I used to tell the police chief... Don't question me on how many medics or ambulances I need for an EMS call and I won't question why you need three squad cars for a "kids skateboarding in a parking lot" call.

BlueLion wrote:I don't consider cops and firefighters (as well as doctors, nurses, emt's, paramedics teachers etc) heroes. We voluntarily signed up for this line of work, therefore were just "doing our job". Firefighters please..1% of their time is fighting some kind of fire. In the early 1970's many communities were looking at the concept of Public Safety Departments so they could cut down on the number of firemen and police officers would perform the same services as a fireman,needless to say this idea wasn't popular with either side. The bottom line is that fire departments just aren't cost effective. Since the 1970's the fire departments have waged a very effective PR effort to justify their existence. For instance, why the do fire departments seem to think they have to respond to every auto accident in there big ass trucks, then have 3 or 4 of them just stand around?

In conclusion, my idea of a hero, is a civilian that risks his life to save another, or the military member that goes beyond the call of duty.

Very well said regarding the "hero" status and the PR...as I said before, EMS can't do too much PR or say much per incident b/c of HIPAA.

I dislike having an engine respond to every medical call as is standard in some cities...I'm competent to do my job, thank you very much.

Fire is often the overall quietest, easiest of emergency services, and yes, I include hydrant checks. Of course, there are moment of intense action, but overall... (Once again, I'm not including wildfires. That's a field you really have to earn your keep in. And with the government handling incident response, even that is often stupidly managed and incredibly wasteful.)

Anyway, I really have had five fire units respond to help one patient (Fall over the Rims.) with my ambulance. Five. Per FD dispatch. There is something wrong with that, at least when only three FFs ever actually did anything.

I agree that a fire unit isn't needed for your typical EMS call, but I sure like having the hands at the scene of a crash. Sure makes carrying a backboard a hell of a lot easier!

We run with crews of three per ambulance on 9-1-1 calls and two for interfacility transfers.

9/11 was (at least in Cali) used by many departments as a fine political tool for their own purposes. Their salaries were significantly increased afterwards.

I'll concur with that statement! Ah My Ride only staffs 2/ambulance, but I worked for one that staffed three. That made a lot of difference. That system also didn't need fire as much, because they were able to lift.

I've received pages before for motor vehicle calls where, for whatever reason, dispatch decided not to send fire. Once the engine was almost finished with hydrant checks and I suppose they didn't want to send the 2nd from station. Silly dispatchers, engines are for keeping me from getting run over.

Anyway, you'd know much more about resource utilization with your experience. You've also worked with bigger systems than I have. Although I've worked with Type I Incident Command on wildfires, the biggest service area I've worked for only covered 130,000...of course, when they blacked out our units reducing us down to 2, things got pretty busy. Did you have the funds to staff your agency well? Ah My Ride was pretty notorious for having X number of 911s holding at system status 0.

Mark wrote:

BlueLion wrote:For instance, why the do fire departments seem to think they have to respond to every auto accident in there big ass trucks, then have 3 or 4 of them just stand around?

Liability. Besides, the fire department does the actual cutting apart of the vehicles. And anytime you have leaking gas and other fluids, you need a charged line in case a fire breaks out when the medics are working on the patients in the wrecked vehicles.

If you didn't have fire trucks there with their rescue tools and water, then you'd simply have EMS vehicles there doing the same service. You need one ambulance for every critical patient (or every two minimally-injured patients). A rescue truck with the tools and a pumper-type truck with the water and foam at a minimum.

Yea, they can respond after the state trooper, sheriff, or local police advises they are needed, or they can have a rescue team respond in a pickup type vehicle that staffed with the tools needed. Sure would save a gallon or two in fuel, and those damn firetrucks wouldn't be parked blocking traffic.

Lucas wrote:
Anyway, you'd know much more about resource utilization with your experience. You've also worked with bigger systems than I have. Although I've worked with Type I Incident Command on wildfires, the biggest service area I've worked for only covered 130,000...of course, when they blacked out our units reducing us down to 2, things got pretty busy. Did you have the funds to staff your agency well? Ah My Ride was pretty notorious for having X number of 911s holding at system status 0.

Staffing, thankfully, has never been an issue. Between you and me, we budget for three on every call (including interfacilities), so that gives us more funds to play with to fiddle with staffing in general. We also maintain a policy of no 911 calls will ever be on hold; every emergency call gets an ambulance on the road within three minutes. Our department has four trucks and all four are out at the same time only once a year on average. We frequently, thanks to a liberal mutual aid policy with surrounding departments, move ambulances into our area if three trucks or more are called out at the same time. The mutual aid plan calls for moving trucks between departments at no cost to the requesting department. And, of course, we gladly move our trucks into their districts free of charge when requested.

Of course, I'm just a sideline observer now. I've been formally retired for three years, but I just can't break away completely.

Like these?

Mark wrote:... but never paramedics?

[rant]

Why do people diss paramedics when it comes to the hero shit?

[/rant]

Two months ago you wrote:

I'm an altruist. More people can benefit if Mr. Moneybags stopped being a playboy and contributed more to society, rather than living with a "mine, all mine" money-grubbing philosophy. It's not jealousy. It's bewilderment as to why someone would want to live their life high on the hog while others stuggle just around the corner. Such selfishness is not in my nature.

My income last year was $7200 gross. I still managed to donate $650 to charity and volunteered hundreds of hours helping addicts to make their lives better in treatment facilities. I did it simply because others needed it more than me.

Now you want to be a hero?????

Which is it, hero or altruist?

BlueLion wrote:Yea, they can respond after the state trooper, sheriff, or local police advises they are needed, or they can have a rescue team respond in a pickup type vehicle that staffed with the tools needed. Sure would save a gallon or two in fuel, and those damn firetrucks wouldn't be parked blocking traffic.

Unfortunately, it doesn't work that way. NFPA and other industry standards dictate who and what responds...not a cop. Minimal response to a crash with injuries is two ambulances (one code three and one code two), a pumper truck (for fire suppression or stand-by), and a rescue truck (with the tools and manpower).

I should mention that around here, an ambulance is called an ambulance. A rescue unit is a fire truck that carries a shitload of tools and manpower and doesn't transport patients. It carries no water or hoses.

Here's what a rescue unit looks like....at least around here:

Boris wrote:
Which is it, hero or altruist?

You miss the point. I'm complaining that people don't recognize EMS as an important branch of public safety, i.e., worthy of being labelled heroic. Personally, I've never thought of MYSELF as a hero. Just doin' a job.